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t I s.,~, ~o~i~=~e~tip~,~ ~ MARION COUNTY
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<br /> ....... '" "' :} 7 .., e8-5 7
<br /> "'" MECHANICAL PERMIT
<br />By:
<br />
<br />Type of Permit:
<br />
<br />Address:
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<br />98214, l eat, 8 ay ,e- lid., - Sta Irt e
<br />
<br />( ) Will call for inapecSon
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<br />BLDG, PERMIT NO:
<br />MECH. PERMIT NO:, '~''$ ''~5~
<br />
<br />Owner:
<br />
<br />Phone:
<br />
<br />installer:
<br />
<br />Phone:
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<br />.Address: ,.,,,~,O, ~X 56 - ~J3e,~
<br />Address: ~"~8~O pZ'~.~le 1R~, S,,,~,
<br />
<br />Application is made for: ( X ) New Installation ( ) Replacement
<br /> ( ) Addition ( )Gas Connection
<br />
<br /> NO, FEE AMOUNT
<br /> Base Price .......................... '1 , 10,00
<br />
<br /> Forced ~!,r furnace 100,000 BTU or less 1 6-00 6,00
<br /> Forced air furnace over 100 000 BTU 7,50;
<br /> Floor Furnace 6.00,
<br /> Suspended Heater 6,00' , ......
<br /> Wall Heater 6.00
<br /> Floor MOunted Unit Heater 6,00
<br /> Heat ,Pump ....... 6,00
<br /> Air Handling Unit to 10,000 cu, ft. 4,50
<br /> Air Handling Unit over 10.000 cu. ft., ............ 7.50
<br /> Evaporative Cooler 4,50
<br /> Exhaust System Commer~'ial ..... 4.,50,
<br /> Hoed and Exhaust Commercial 4.50
<br /> Domestic Range Hoods 1 4.50 ~,
<br /> Domestic Exhaust Fa~s &,..D_ryer V~'nts 1- &l~yl~ -~ 3:(3(3 ¢3:~t3
<br /> D0mestlc,W.°,,gd .Sto,ve [ ~'~'"la 7,50
<br /> Commercial or Industrial Incinerator I .+4 14 ,t,v 30.00
<br />"~ire Damper ........ -- -" 3,00
<br />Gas Water Heater 7.50
<br /> G~s~¢C6nd~ctlon w/o Appliance :(1'~ each) 2.00
<br /> over 4- $8.00 plus ea. addnl. ,50
<br /> Appliance or accessory to any heating or
<br /> Comfort cooling system net covered 4.50
<br /> Other (as per Mechanical Cod~,)I
<br />
<br />Please return COMPLETE APPLICATION 4%
<br />with the indicated fee. PLAN REVIEW FEE ~
<br />INVESTIGATION FEE
<br />FLEET SURCHARGE
<br />TOTAL
<br />
<br />Appliance eleo~C
<br />Make DAY &
<br />
<br />BTU input Floor area
<br />Vent Size Fuel
<br />
<br /> COMMENTS:
<br />
<br />· I agree to install according to the submitted plans and specifications, the laws of the State of Oregon and the
<br />Ordinances of Marion County, PERMIT EXPIRES IF WORK NOT COMMENCED WITHIN 180 DAYS, I further warrant
<br />that I comply with the provisions of ORS 701.005 to 701,125 because:
<br />
<br />( 3¢ ) I am a registered contractor or ( ) the authorized representative of a registered contractor,
<br />( } The work will be performed hy a registered contractor. ,
<br />( ) I am performing work on a property I own or occupy, J
<br />( ) Other (please s~~ ' 1
<br />SIGNATURE OF APPLICANT~~-~/~ ~ BLDRS BOARD REGISTRATION # ,.~L0~b~,, i~
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